Globall War of Terror - Preparedness
May. 26th, 2018 09:37 pm![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
drewkittyGloball War of Terror - Preparedness
This is the last element of the RTX to be graded.
Janine, the vet surgeon and a schoolteacher - the latter in charge of our stretcher bearers - are the leaders whose performance is being evaluated.
I am the evaluator.
I start with the infirmary. It is merely half full. Normally it is full, but we have - per the SOP - established a satellite ward where patients who can be safely moved have been relocated, to make room for battle casualties.
I inspect the dressing station outside the infirmary. It is not for clothing. It is for rapid assessment and immediate lifesaving treatment of the wounded.
The woman wearing the "TRIAGE" vest had been a dental assistant, of all things. But she at least knew her way around an airway, and that skill was valuable.
I looked carefully at the printed triage tags, the supplies of bandages and dressings cut from salvaged linen, the nearly pointless AED in pride of place on our pathetic imitation of a hospital crash cart. I did not pop it open and check expiration dates. It was what it was. The telltale idiot light was lit and that would have to do.
I checked the whiteboard, the master status chart of who was admitted and how they were doing. It was full.
"Doctor," I exaggerated, "where would you record the status of incoming casualties?"
"On the whiteboard," she said, as if to someone slow.
"The full whiteboard ... or is there another whiteboard?"
I had personally seen to it that the infirmary had been allocated three whiteboards - one for status, one for mass casualties, one for training.
After a short interval, the second whiteboard was located. It was in the vet surgeon's office, tracking her supply needs.
The third whiteboard had been 'borrowed' by some coding shop or another and not returned.
"I would clear this board," she started to say, when I carefully took three digital camera photos of the board. Then I wiped it clean and set it up in pride of place at the front.
I then opened a list I had sketched together the previous day, of potential battle casualties.
"Patient 1 has a through-and-through GSW to the right arm. He is breathing 20 times a minute, has a strong radial pulse by palpation, and is alert and oriented... patient 2 was struck on the head by a piece of debris and was not wearing a helmet. He is breathing 40 times per minute, capillary refill greater than two seconds, and is not alert and does not know where he is ..."
I wondered who was going to start writing this down on the status board.
The vet surgeon looked at me, looked at the blank board, visibly controlled her fury, and directed an orderly to start writing on the board. He did the best he could, but he made several mistakes in triage categories.
I took a marker to the board, crossed out three names, added information to seven more, then started reading again.
"Patient 19 has a through and through GSW to the lower face. He is not breathing and not conscious. Patient 20 was in a car accident without airbag deployment, not wearing a seat belt, now is complaining of chest pain from impact, is breathing 32 times per minute, cap refill less than 2 seconds, and she is alert. Patient 21..."
The staff were staring at me. If anything, I was going easy on them. They might have to receive hundreds of casualties, not just a couple dozen.
But they were now visualizing what they would have to be doing, while standing in the places where they would be doing the necessary tasks.
And this was the first time. There had not been drills.
I knew this, of course. The guard post in the infirmary had made regular reports. I had specifically instructed that I be notified at any time, day or night, if the infirmary conducted a drill. And I had received no notifications.
I took a picture of the newly filled white board. I E-mailed all four photos to the vet surgeon.
I didn't have enough curses. Sometimes the thing speaks for itself.
I tried to calm down during my walk to Building D.
The battle dressing station established inside D building was no better. In fact it was substantially worse. A few first aid kits clearly grabbed off walls at the last minute sat next to a single forlorn stretcher, obviously stolen from a stretcher bearer team.
We didn't have the supplies to establish a battle dressing station in every building, which would have been the ideal. But we did have three complete sets in addition to infirmary stocks: one kept in the motor pool, one kept in the cafeteria, and the rolling set (literally) that should have been here.
I opened up the first aid kits. They weren't even minimally stocked to Firecracker levels, let alone prewar standards. And would not have served a mass casualty situation well in any case.
Enough was enough. I keyed up my radio.
"Echo 18, Control, priority life safety investigation. Where is the portable battle dressing station? It was last seen in the outside storage near Building C dock about 1500 hours yesterday."
It took a couple minutes, but Control confirmed that it was still where it was supposed to be, for values of before the exercise.
It hadn't been moved.
Janine arrived, having monitored my radio traffic. She took one look at the pathetic attempt at a dressing station and completely, utterly lost her shit.
"Do any of you idiots have any idea how many people would be DEAD NOW?"
She explained in words of one syllabus, sprinkled with obscenity and profanity, about the need to go get the supplies - where they were kept - whose job it was to go get them - whose job it was to report that they had not been found - and to go get them Right Now.
We traced the problems. Someone's radio had been on the wrong channel. Another person's radio hadn't been on. A third had been on both the Reaction Team and the stretcher bearer rosters, and had responded with the Reaction Team. This goof was magnified by the fact they were the only one in this building with the necessary keys.
Eight minutes later, the equipment arrived.
Janine and I started setting up. Shamed, the remaining employees whose job it was joined us.
_Then_ I took out the same checklist I had inflicted on the infirmary. Fortunately, one of the cart sides had been covered with glass for the specific purpose of being used for casualty tracking. Once they found dry erase markers.
Once I established that their triage skills were on par with their other preparedness (shudder), I took Janine for a walk to a nearby conference room.
"Simulated radio traffic. This is Reaction Command to Fire Brigade. Give me a ringdown on the disposition of your stretcher bearer teams."
I decided I didn't even need to talk to the schoolteacher. She had already earned an F for effort, three times. 1) Not setting up. 2) Not rushing to the scene in response to my radio traffic. 3) Her people had let her get blindsided.
Armed with nothing more than a whiteboard and a dry erase marker, Janine proceeded to talk while she was writing, using proper radio protocol. I was recording on my wifi cell and took a picture at the end.
Her description matched the layout I had observed of the stretcher bearer teams.
That she had a subordinate who needed replacing was not a point I needed to belabor.
Now it was her turn in the barrel.
"Security Control to Fire Brigade. We have a structure fire at the southwest corner of Building J. Black smoke is showing. Apparent start is from direct weapons fire. Scene is not repeat not secure. Acknowledge."
I walked Janine through how she would set up the problem. What could be safely done from a distance. How she would stage her teams. Once we regained area control, how they would respond and with what equipment.
Then we walked outside and to Janine's golf cart.
"Do it," I said. "Roll your responders, make it happen."
She did. A single trained firefighter took control of several untrained employees, with axes and several fire extinguishers. Another trained firefighter went to the building's Fire Control Room and awaited instructions to dump the building, flood areas, ventilate areas, or at last resort fully evacuate including response personnel and let the building burn. Her one trained engineer started to set up a water supply operation once I informed her that the water pressure had fallen to zero.
By mutual consent we stopped the exercise before doing major damage to the building, although Facilities would have to replaster a wall after enthusiastic application of a pike pole looking for notional hot spots.
"The fire has been extinguished. How would you deploy your assets to conduct a salvage operation, given the following damage?"
She told me. I carefully did not say, "Make it happen," because while salvage was important, it was not exactly lifesaving. It was mission related, however, as you can't code in a burned out shell.
Then I had Janine come with me back to the infirmary, where the two of us had a heart to heart with the vet surgeon.
I set the tone by appropriating her chair and desk. It went downhill from there.
By the time we were done, the three of us were in agreement that the vet surgeon - although nominally a manager herself - would be taking some management training classes. Also that her first infirmary drill would be held in two days with cooperation from Security and the Reaction Team, who would be playing the part of casualties.
I had the feeling that I might be volunteering as a real life casualty if the vet surgeon and I happened to meet in a dark alley - if I were unarmed, blind drunk and had completely lost my will to live. And if someone spotted her a machine pistol, and perhaps a brain transplant.
We needed competent medical staff so very badly. But if she were say, the motor pool manager, I'd be asking the SLE to perp walk her out the South Gate before you could say "Stat!"
Janine excused herself to conduct a post-incident debrief with her firefighters, and to "find a new Stretcher Bearer manager!" I may have left out some profanity.
I went to Control just long enough to borrow the supervisor's office and write an E-mail, to which I attached some photos.
Infirmary Preparedness: FAIL
Stretcher Bearer Dressing Station: FAIL
Stretcher Bearer Deployment: MARGINAL PASS
Fire Brigade Response: PASS
We all had our work cut out for us. Then my E-mail chimed. My evaluator was the Reaction Force commander.
Security Control: PASS
H5 Observation Post: PASS WITH DISTINCTION
Security Response Force: PASS WITH DISTINCTION
Situational Awareness: PASS
Adversary Force: PASS WITH DISTINCTION
It was time for me to start digging.
As far as I was concerned, we had failed two elements. And I could only blame one on Major Anderson.
This is the last element of the RTX to be graded.
Janine, the vet surgeon and a schoolteacher - the latter in charge of our stretcher bearers - are the leaders whose performance is being evaluated.
I am the evaluator.
I start with the infirmary. It is merely half full. Normally it is full, but we have - per the SOP - established a satellite ward where patients who can be safely moved have been relocated, to make room for battle casualties.
I inspect the dressing station outside the infirmary. It is not for clothing. It is for rapid assessment and immediate lifesaving treatment of the wounded.
The woman wearing the "TRIAGE" vest had been a dental assistant, of all things. But she at least knew her way around an airway, and that skill was valuable.
I looked carefully at the printed triage tags, the supplies of bandages and dressings cut from salvaged linen, the nearly pointless AED in pride of place on our pathetic imitation of a hospital crash cart. I did not pop it open and check expiration dates. It was what it was. The telltale idiot light was lit and that would have to do.
I checked the whiteboard, the master status chart of who was admitted and how they were doing. It was full.
"Doctor," I exaggerated, "where would you record the status of incoming casualties?"
"On the whiteboard," she said, as if to someone slow.
"The full whiteboard ... or is there another whiteboard?"
I had personally seen to it that the infirmary had been allocated three whiteboards - one for status, one for mass casualties, one for training.
After a short interval, the second whiteboard was located. It was in the vet surgeon's office, tracking her supply needs.
The third whiteboard had been 'borrowed' by some coding shop or another and not returned.
"I would clear this board," she started to say, when I carefully took three digital camera photos of the board. Then I wiped it clean and set it up in pride of place at the front.
I then opened a list I had sketched together the previous day, of potential battle casualties.
"Patient 1 has a through-and-through GSW to the right arm. He is breathing 20 times a minute, has a strong radial pulse by palpation, and is alert and oriented... patient 2 was struck on the head by a piece of debris and was not wearing a helmet. He is breathing 40 times per minute, capillary refill greater than two seconds, and is not alert and does not know where he is ..."
I wondered who was going to start writing this down on the status board.
The vet surgeon looked at me, looked at the blank board, visibly controlled her fury, and directed an orderly to start writing on the board. He did the best he could, but he made several mistakes in triage categories.
I took a marker to the board, crossed out three names, added information to seven more, then started reading again.
"Patient 19 has a through and through GSW to the lower face. He is not breathing and not conscious. Patient 20 was in a car accident without airbag deployment, not wearing a seat belt, now is complaining of chest pain from impact, is breathing 32 times per minute, cap refill less than 2 seconds, and she is alert. Patient 21..."
The staff were staring at me. If anything, I was going easy on them. They might have to receive hundreds of casualties, not just a couple dozen.
But they were now visualizing what they would have to be doing, while standing in the places where they would be doing the necessary tasks.
And this was the first time. There had not been drills.
I knew this, of course. The guard post in the infirmary had made regular reports. I had specifically instructed that I be notified at any time, day or night, if the infirmary conducted a drill. And I had received no notifications.
I took a picture of the newly filled white board. I E-mailed all four photos to the vet surgeon.
I didn't have enough curses. Sometimes the thing speaks for itself.
I tried to calm down during my walk to Building D.
The battle dressing station established inside D building was no better. In fact it was substantially worse. A few first aid kits clearly grabbed off walls at the last minute sat next to a single forlorn stretcher, obviously stolen from a stretcher bearer team.
We didn't have the supplies to establish a battle dressing station in every building, which would have been the ideal. But we did have three complete sets in addition to infirmary stocks: one kept in the motor pool, one kept in the cafeteria, and the rolling set (literally) that should have been here.
I opened up the first aid kits. They weren't even minimally stocked to Firecracker levels, let alone prewar standards. And would not have served a mass casualty situation well in any case.
Enough was enough. I keyed up my radio.
"Echo 18, Control, priority life safety investigation. Where is the portable battle dressing station? It was last seen in the outside storage near Building C dock about 1500 hours yesterday."
It took a couple minutes, but Control confirmed that it was still where it was supposed to be, for values of before the exercise.
It hadn't been moved.
Janine arrived, having monitored my radio traffic. She took one look at the pathetic attempt at a dressing station and completely, utterly lost her shit.
"Do any of you idiots have any idea how many people would be DEAD NOW?"
She explained in words of one syllabus, sprinkled with obscenity and profanity, about the need to go get the supplies - where they were kept - whose job it was to go get them - whose job it was to report that they had not been found - and to go get them Right Now.
We traced the problems. Someone's radio had been on the wrong channel. Another person's radio hadn't been on. A third had been on both the Reaction Team and the stretcher bearer rosters, and had responded with the Reaction Team. This goof was magnified by the fact they were the only one in this building with the necessary keys.
Eight minutes later, the equipment arrived.
Janine and I started setting up. Shamed, the remaining employees whose job it was joined us.
_Then_ I took out the same checklist I had inflicted on the infirmary. Fortunately, one of the cart sides had been covered with glass for the specific purpose of being used for casualty tracking. Once they found dry erase markers.
Once I established that their triage skills were on par with their other preparedness (shudder), I took Janine for a walk to a nearby conference room.
"Simulated radio traffic. This is Reaction Command to Fire Brigade. Give me a ringdown on the disposition of your stretcher bearer teams."
I decided I didn't even need to talk to the schoolteacher. She had already earned an F for effort, three times. 1) Not setting up. 2) Not rushing to the scene in response to my radio traffic. 3) Her people had let her get blindsided.
Armed with nothing more than a whiteboard and a dry erase marker, Janine proceeded to talk while she was writing, using proper radio protocol. I was recording on my wifi cell and took a picture at the end.
Her description matched the layout I had observed of the stretcher bearer teams.
That she had a subordinate who needed replacing was not a point I needed to belabor.
Now it was her turn in the barrel.
"Security Control to Fire Brigade. We have a structure fire at the southwest corner of Building J. Black smoke is showing. Apparent start is from direct weapons fire. Scene is not repeat not secure. Acknowledge."
I walked Janine through how she would set up the problem. What could be safely done from a distance. How she would stage her teams. Once we regained area control, how they would respond and with what equipment.
Then we walked outside and to Janine's golf cart.
"Do it," I said. "Roll your responders, make it happen."
She did. A single trained firefighter took control of several untrained employees, with axes and several fire extinguishers. Another trained firefighter went to the building's Fire Control Room and awaited instructions to dump the building, flood areas, ventilate areas, or at last resort fully evacuate including response personnel and let the building burn. Her one trained engineer started to set up a water supply operation once I informed her that the water pressure had fallen to zero.
By mutual consent we stopped the exercise before doing major damage to the building, although Facilities would have to replaster a wall after enthusiastic application of a pike pole looking for notional hot spots.
"The fire has been extinguished. How would you deploy your assets to conduct a salvage operation, given the following damage?"
She told me. I carefully did not say, "Make it happen," because while salvage was important, it was not exactly lifesaving. It was mission related, however, as you can't code in a burned out shell.
Then I had Janine come with me back to the infirmary, where the two of us had a heart to heart with the vet surgeon.
I set the tone by appropriating her chair and desk. It went downhill from there.
By the time we were done, the three of us were in agreement that the vet surgeon - although nominally a manager herself - would be taking some management training classes. Also that her first infirmary drill would be held in two days with cooperation from Security and the Reaction Team, who would be playing the part of casualties.
I had the feeling that I might be volunteering as a real life casualty if the vet surgeon and I happened to meet in a dark alley - if I were unarmed, blind drunk and had completely lost my will to live. And if someone spotted her a machine pistol, and perhaps a brain transplant.
We needed competent medical staff so very badly. But if she were say, the motor pool manager, I'd be asking the SLE to perp walk her out the South Gate before you could say "Stat!"
Janine excused herself to conduct a post-incident debrief with her firefighters, and to "find a new Stretcher Bearer manager!" I may have left out some profanity.
I went to Control just long enough to borrow the supervisor's office and write an E-mail, to which I attached some photos.
Infirmary Preparedness: FAIL
Stretcher Bearer Dressing Station: FAIL
Stretcher Bearer Deployment: MARGINAL PASS
Fire Brigade Response: PASS
We all had our work cut out for us. Then my E-mail chimed. My evaluator was the Reaction Force commander.
Security Control: PASS
H5 Observation Post: PASS WITH DISTINCTION
Security Response Force: PASS WITH DISTINCTION
Situational Awareness: PASS
Adversary Force: PASS WITH DISTINCTION
It was time for me to start digging.
As far as I was concerned, we had failed two elements. And I could only blame one on Major Anderson.
